RELEASE OF LIABILITY AND INDEMINIFICATION
In consideration for Shani Dreams of Jewelry's acceptance of this registration, I hereby agree to indemnify and hold harmless Shani Dreams of Jewelry, its officers, agents, or employees from any liability or claim or action for damages resulting from or in any way arising out of the participation in any Shani Dreams of Jewelry classes, programs, camps, birthday parties by the person registered. I further understand and agree: (1) to assume all risks inherent in the activities which are available and in which l may participate, and understand that these activities involve risk to my person and property and (2) to assume the risks, if any, arising from the conditions and use of equipment and facilities. l further understand and agree that there may be risks and dangers not known or reasonably foreseeable at this time.
In the event of injury or illness while the participant is attending the recreation activity, l hereby authorize the Shani Dreams of Jewelry to consent to medical treatment on behalf of my child as deemed necessary. The undersigned, as parent or legal guardian of the child identified on this form, hereby authorizes Shani Dreams of Jewelry and its officers, employees, and agents into whose care the registered child has been entrusted, to consent to the advice of trained Orange County Fire Authority personnel. This authorization to consent to treatment of the minor identified above is given to the Shani Dreams of Jewelry in conjunction with any activity or event in which the minor’s care is entrusted to Shani Dreams of Jewelry.
Shani Dreams of Jewelry may take, use, and publish photos of participants for publicity purposes. Photos of participants are used in Shani Dreams of Jewelry’s website and media publications to promote recreation classes and programs. I hereby grant Shani Dreams of Jewelry permission to use my likeness, name, voice and words in any print media account of this event or activity free of charge. IF THE PARTICIPANT IS A MINOR, his or her custodial parent or legal guardian must read and execute this agreement. I hereby warrant that I am the custodial parent or legal guardian of the participant listed above, who is a minor, on my own and said minor’s behalf to the terms and conditions of the foregoing release.
Shani Dreams of Jewelry takes your privacy seriously. Instructors will receive only the name, current age, and phone number of participants. E-mail addresses will only be utilized for Shani Dreams of Jewelry correspondence related to your registration, promotions, and to inform you of upcoming events. Unless required by court order, your information will not be shared with other agencies, departments, businesses, or individuals.
Parent's Signature______________________ Date_________ Name of child(ren)______________________________